The Supportive and Palliative Radiation Oncology Service: A Dedicated Model for Palliative Radiation Oncology Care

R adiation therapy (RT) has been an established modality for treating various types of cancers since the early 1900s. It became more broadly utilized in cancer therapy beginning in the 1960s, with greater accessibility to radioactive sources such as cobalt-60 and the emergence of the linear accelerator. The linear accelerator is a piece of equipment that instead of requiring a radioactive source, uses electricity to generate high-energy photons (x-rays) or charged particles (i. the specialty of radiation oncology and its technologies have continued to evolve and now have a central role in treating many types of cancers, both as an independent modality and in combination with chemotherapy When RT is delivered, it is most often delivered as high-energy pho-tons, which can deeply penetrate tissue, or electrons, which deliver superficial radiation therapy generated by a linear accelerator. Though less commonly used, brachytherapy (placement of radioactive sources into the tumor) is also an important modality for treating tumors. In whatever form, RT requires a simulation (a method of reproducibly setting up the patient for each treatment , often with immobilization devices and freckle-sized tattoos as setup points), followed by a CT scan of the region of interest. Next, radiation planning, in which the tumor target is treated while minimizing the dose to normal structures, is performed. Confor-mal planning is the use of computer modeling of radiation-beam arrangements to optimize targeting of the tumor while sparing normal tissues. Intensity-modulated radiation therapy (IMRT) is a type of conformal therapy that allows thin radiation beams of varying intensity to generate high conformality of the dose to the target. Stereotactic radiosurgery (SRS) is high dose-per-treatment RT delivered in a single treatment (or up to five treatments) using high